Provider Demographics
NPI:1003213158
Name:HEALING JOURNEY COUNSELING, LLC
Entity Type:Organization
Organization Name:HEALING JOURNEY COUNSELING, LLC
Other - Org Name:JOURNEY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GABRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-414-7072
Mailing Address - Street 1:551 BARBERTON DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6319
Mailing Address - Country:US
Mailing Address - Phone:757-414-7072
Mailing Address - Fax:
Practice Address - Street 1:101 N LYNNHAVEN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7523
Practice Address - Country:US
Practice Address - Phone:757-414-7072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1861562472Medicaid